36D2184933 CLIA NUMBER - COAL GROVE PHARMACY

Laboratory Demographics

  • CLIA Code: 36D2184933
  • Facility Name: COAL GROVE PHARMACY
  • Facility Address: 600 MARION PIKE
    COAL GROVE, OH
    ZIP 45638
  • Facility Phone: 740 533-2479
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JASON PLUMMER
  • NPI Number: 1316493356
  • Taxonomy: 122300000X - Dentist

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CLIA Record

Field Name Field Value
CLIA Number 36D2184933
LAB Type Pharmacy
Facility Name COAL GROVE PHARMACY
Street 600 MARION PIKE
City COAL GROVE
State OH
ZIP 45638
Phone 740 533-2479
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/27/2024
Certificate Expiration Date 5/26/2026
Facility Type Pharmacy
Lab Director JASON PLUMMER

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This page was last updated on: 9/29/2025